Agency Assessment

To assess agency readiness to implement an evidence-based practice for adolescents with substance use disorders

Substance Use Disorders

Butler, Clermont,  and Hamilton Counties, OH

$25,000

2006

9 months

A grant of $25,000.00 was approved on May 10, 2006 to assess agency readiness to implement an evidence-based practice for adolescents with substance use disorders.  A variance to extend the grant by two months was approved so that a staff member could attend a national meeting on treatment effectiveness.

A Change Team was formed and met weekly for six months to assist staff participation in the change process, identify agency challenges, make decisions and monitor outcomes, and identify the right EBP for the program. Surveys, interviews and drill down methods were conducted with all Alcohol and Drug services staff, clients and families. Marketing, program development and payor contracts were identified as the areas most critical for change.

Telephone surveys of twenty agencies that provide services similar to Christ Hospital adolescent treatment services were conducted to collect information on fourteen variables including program structure, census, level of care provided and evidenced based practices employed.  Interviews were conducted with the Juvenile Court, Alliance Behavioral Care and Alliance EAP to determine what needs exist that the adolescent program can meet.

A literature review was conducted from a number of resources. Treatment models were reviewed and site visits conducted at agencies using ATM, Global Appraisal of Individual Needs (GAIN), and the Seven Challenges.  An evaluation grid was created with a comparison of the EBPs.

The Organizational Readiness for Change surveys were administered to administrative and clinical staff.

Site visits were made to Chestnut Health Systems in Bloomington, IL, NorthKey Community Care in Covington, KY, Fairbanks Alcohol and Drug Treatment in Indianapolis, IN, and Sojourner Home in Hamilton, OH.

The Change Team submitted a formal proposal to upper management, who approved the following:

• A marketing/capacity building plan for increasing the census of the adolescent substance abuse unit - Much of the marketing plan is implemented.
• A recommendation for changing from a five day to a three day after school program that better accommodates client and family needs
• A recommendation for implementing GAIN – the grantee submitted a proposal for a start up grant to implement this EBP.

A Change Team was formed upon notice of the grant award. The Program Manager is the Project Director. Four key persons were trained in the GAIN model in October, 2007. They were all certified trainers by January, 2008 and trained four more in April, 2008.

A list of facilitators and barriers was submitted. The key facilitators were the Change Team, Drill Down, open ended survey questions, understanding animosity toward upper management, ADKAR training. Key barriers were time commitments, difficulty obtaining a grasp of the EBPs, no direct access to finance department, adolescent survey instrument that was too cumbersome, and little racial diversity in staff.

Implementation of the Global Appraisal of Individual Needs (GAIN)

To implement the Global Appraisal of Individual Needs as an assessment instrument for adolescents

Substance Use Disorders

Hamilton County, OH

$45,950

2007

24 months